摘要
目的：综合指标评价阿苯达唑脂质体(L-ABZ)治疗人体包虫病的疗效，并进行安全性考察，为该药在临床的应用提供客观依据。方法：临床治疗66例包虫病患者，其中囊型包虫病56例(多脏器并发15例)，口服阿苯达唑脂质体10mg/kg·d，一天两次，连续服用；泡型包虫病10例(多脏器并发3例)，常规口服剂量为10mg/kg·d，疗程3—12个月，通过影像学指标动态随访观察，并临床症状和体征及生化指标进行疗效评价，动态随访3—24个月。按治愈率，有效率，部分有效率，无效率以及总有效率判断疗效，并对单囊型及与多子囊型以及原发、复发病人进行对照研究。结果：66例患者中，治愈20例(20/66)，治愈率：30.3％；有效29例(29/66)，有效率：43.9％；部分有效10例(10/66)，部分有效率：15.1％：无效7例(7/66)，无效率：10.6％；总有效率：89.3％(59/66)。其中，囊型病例分析中，单囊型的治愈率明显高于多子囊型，但二者的有效率无显著性差异；对于原发、复发病人的治疗阿苯达唑脂质体的疗效无明显差异。而泡型包虫病患者，约50％病例临床疗效明显：在安全性观察中，主观症状阳性率为13.6％(9/66)，多为胃部不适，腹泻等症状且可迅速缓解，而不影响治疗；主要检测指标阳性率为12.1％(8/66)，主要为肝功能转氨酶轻度异常，多可自行恢复。至今在本系列治疗随访中尚未发现肾功损害及血象异常者。结论：阿苯达唑脂质体口服液是目前有效的一种抗包虫病新药剂型，具有疗效较高，低毒、副作用小、安全性高的特点。初步临床观察显示出其良好的应用前景。
Objective: To assess the therapeutic effacy on liposomal albendazole against human echinococcosis so as to provide more evidence and theoretical basis for further clinical application. Methods: In a total of 66 patients with CE and AE, 56 cases CE (15 cases with multi-organ involved)were orally taken L-ABZ with dosage of l0mg/kg d, twice daily for 3-12 months.10 AE patients(3 cases with multi-organ involved) were given the same dosage for 3-12 months.Therapeutic effect and reliability for L-ABZ have been evaluated by imagins (US,CT,MRI),clinical manifestations,labortory tests and followed up routinely from 3 to 24 months. The common therapeutic standards were classified as cure, effectiveness, partical effectiveness and noneffectiveness. Effects of L-ABZ were analyzed for the types of simple cyst and multiple daughter cyst.At the same time,postive rate about subjective symptoms and labortory tests were regarded as standard of side-effects of L-ABZ. Result: In total of 66 patients.20 cases(30.3%) were cured, 29 cases(43.9%) as effective, 10 cases(15.1%) as partial effective, 7 cases (10.6%) as noneffective,The total effective rate was 89.3%.By analyzing,the effects of L-ABZ for type of simple cyst(CE)) is more sensitive than type of multiple daughter cyst(CE2) in cure of rate, however, there were not different between CE] and CE2 by contrasting the
total effective rate,same as the patients who episode firstly and secondly.In AE patients,over half were better treated. In observation of side-effects, postive rate about subjective symptoms and labortory tests wrere respectively 13.6% (9/66) and 12.1% (8/66) , disorder of digestive system and abnormality of liver function were common,however,these symptom and abnormality would ameliorate,so,the course of treatment have not been terminated. Conclusion: L-ABZ can be considered as a new furmulation which had better effective for the treatment of human echinococcosis,and its side-effects is slight,thus,it showed more promising for clinical purpose in future.
引文
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